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Research ArticleOriginal Research

Impact of Primary Care Attributes on Hospitalization During the COVID-19 Pandemic: A Nationwide Prospective Cohort Study in Japan

Takuya Aoki, Yoshifumi Sugiyama, Rieko Mutai and Masato Matsushima
The Annals of Family Medicine January 2023, 21 (1) 27-32; DOI: https://doi.org/10.1370/afm.2894
Takuya Aoki
1Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
2Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
MD, PhD, MMA
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  • For correspondence: taoki@jikei.ac.jp
Yoshifumi Sugiyama
1Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
3Division of Community Health and Primary Care, Center for Medical Education, The Jikei University School of Medicine, Tokyo, Japan
MD, PhD
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Rieko Mutai
4Department of Adult Nursing, The Jikei University School of Nursing, Tokyo, Japan
RN, MSN, PhD
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Masato Matsushima
1Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
MD, PhD, MPH
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  • RE: positive and negative reviews on primary care attributes on hospitalization during covid
    Jaisingh Rajput and Prajakta Rajput
    Published on: 31 December 2023
  • Improvement in self-management for the prevention of hospitalization
    Ryuichi Ohta
    Published on: 05 February 2023
  • Published on: (31 December 2023)
    Page navigation anchor for RE: positive and negative reviews on primary care attributes on hospitalization during covid
    RE: positive and negative reviews on primary care attributes on hospitalization during covid
    • Jaisingh Rajput, Family Medicine physician MD, ABFM
    • Other Contributors:
      • Prajakta Rajput, Family Physician MD.

    Positive Review

    The study published in The Annals of Family Medicine makes a significant contribution by investigating the impact of primary care attributes on hospitalization during the COVID-19 pandemic in Japan. The use of a nationwide prospective cohort study with a representative sample adds credibility to the findings. The incorporation of core primary care attributes assessed through the Japanese version of the Primary Care Assessment Tool (JPCAT) provides a comprehensive framework for analysis. The study's dose-dependent association between overall primary care attributes and decreased hospitalizations, even during a pandemic, is noteworthy and supports the importance of high-quality primary care. The implications for policy recommendations to strengthen primary care systems are well-founded and provide valuable insights for healthcare decision-makers.

    Negative Review

    While the study is commendable in its attempt to explore the association between primary care attributes and hospitalization during the COVID-19 pandemic, it may face limitations in generalizability. The focus on the Japanese adult population aged 40 to 75 years may restrict the applicability of findings to other demographic groups or countries with different healthcare systems. Additionally, the study's reliance on self-reported data from participants raises potential concerns about recall bias and the accuracy of responses. Further, the study could benefit from a more...

    Show More

    Positive Review

    The study published in The Annals of Family Medicine makes a significant contribution by investigating the impact of primary care attributes on hospitalization during the COVID-19 pandemic in Japan. The use of a nationwide prospective cohort study with a representative sample adds credibility to the findings. The incorporation of core primary care attributes assessed through the Japanese version of the Primary Care Assessment Tool (JPCAT) provides a comprehensive framework for analysis. The study's dose-dependent association between overall primary care attributes and decreased hospitalizations, even during a pandemic, is noteworthy and supports the importance of high-quality primary care. The implications for policy recommendations to strengthen primary care systems are well-founded and provide valuable insights for healthcare decision-makers.

    Negative Review

    While the study is commendable in its attempt to explore the association between primary care attributes and hospitalization during the COVID-19 pandemic, it may face limitations in generalizability. The focus on the Japanese adult population aged 40 to 75 years may restrict the applicability of findings to other demographic groups or countries with different healthcare systems. Additionally, the study's reliance on self-reported data from participants raises potential concerns about recall bias and the accuracy of responses. Further, the study could benefit from a more detailed exploration of specific primary care attributes that had a more pronounced impact on reducing hospitalizations. A discussion of potential confounding factors and limitations in the study design would enhance the transparency of the research. Despite these considerations, the study provides valuable insights into the role of primary care during a pandemic and opens avenues for future research in this critical area.

    Show Less
    Competing Interests: None declared.
  • Published on: (5 February 2023)
    Page navigation anchor for Improvement in self-management for the prevention of hospitalization
    Improvement in self-management for the prevention of hospitalization
    • Ryuichi Ohta, Family physician, Unnan City Hospital

    I have read exciting research titled “Impact of Primary Care Attributes on Hospitalization During the COVID-19 Pandemic: A Nationwide Prospective Cohort Study in Japan.”1 This research investigated the association between primary care quality and hospitalization rate during the COVID-19 pandemic. The strong point of the study is the comprehensive assessment of the quality of primary care functions with the validated questionnaire and the clarification of the importance of primary care even during the COVID-19 pandemic. This result will motivate primary care physicians and stakeholders worldwide to drive the quality of primary care and prepare for the next pandemic of new viruses.

    Furthermore, family physicians should improve attitudes and skills regarding self-management. The previous research shows older people suffer from social fear of COVID-19 and are impinged on social interactions, especially in rural contexts.2 Another report in rural contexts suggests that the preference for self-management to usual symptoms can improve quality of life (QOL) among older people during the COVID-19 pandemic.3 For the implementation of the results effectively to older community-dwelling people, family physicians should support their older patients’ self-management to sustain their health, which can contribute to further improving their QOL even in the COVID-19 pandemic.

    Reference
    1. Aoki T, Sugiyama Y, Mutai R, Matsushima M. Impact of Primary Care Attributes on Hos...

    Show More

    I have read exciting research titled “Impact of Primary Care Attributes on Hospitalization During the COVID-19 Pandemic: A Nationwide Prospective Cohort Study in Japan.”1 This research investigated the association between primary care quality and hospitalization rate during the COVID-19 pandemic. The strong point of the study is the comprehensive assessment of the quality of primary care functions with the validated questionnaire and the clarification of the importance of primary care even during the COVID-19 pandemic. This result will motivate primary care physicians and stakeholders worldwide to drive the quality of primary care and prepare for the next pandemic of new viruses.

    Furthermore, family physicians should improve attitudes and skills regarding self-management. The previous research shows older people suffer from social fear of COVID-19 and are impinged on social interactions, especially in rural contexts.2 Another report in rural contexts suggests that the preference for self-management to usual symptoms can improve quality of life (QOL) among older people during the COVID-19 pandemic.3 For the implementation of the results effectively to older community-dwelling people, family physicians should support their older patients’ self-management to sustain their health, which can contribute to further improving their QOL even in the COVID-19 pandemic.

    Reference
    1. Aoki T, Sugiyama Y, Mutai R, Matsushima M. Impact of Primary Care Attributes on Hospitalization During the COVID-19 Pandemic: A Nationwide Prospective Cohort Study in Japan. Ann Fam Med 2023;21(1):27-32. DOI: 10.1370/afm.2894.
    2. Ohta R, Ryu Y, Sano C. Fears Related to COVID-19 among Rural Older People in Japan. Healthcare (Basel) 2021;9(5). DOI: 10.3390/healthcare9050524.
    3. Ohta R, Ryu Y, Sano C. Improvement in Quality of Life through Self-Management of Mild Symptoms during the COVID-19 Pandemic: A Prospective Cohort Study. International Journal of Environmental Research and Public Health 2022;19(11). DOI: 10.3390/ijerph19116652.

    Show Less
    Competing Interests: None declared.
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Annals of Family Medicine: 21 (1)
Annals of Family Medicine: 21 (1)
Vol. 21, Issue 1
January/February 2023
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Impact of Primary Care Attributes on Hospitalization During the COVID-19 Pandemic: A Nationwide Prospective Cohort Study in Japan
Takuya Aoki, Yoshifumi Sugiyama, Rieko Mutai, Masato Matsushima
The Annals of Family Medicine Jan 2023, 21 (1) 27-32; DOI: 10.1370/afm.2894

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Impact of Primary Care Attributes on Hospitalization During the COVID-19 Pandemic: A Nationwide Prospective Cohort Study in Japan
Takuya Aoki, Yoshifumi Sugiyama, Rieko Mutai, Masato Matsushima
The Annals of Family Medicine Jan 2023, 21 (1) 27-32; DOI: 10.1370/afm.2894
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Subjects

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